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I would like to start this discussion, which might help explain some of our caveats regarding HIV meds as being "no big deal."

I suppose dealing with the common drug(s) known as Atripla is a decent starting point.

Atripla, as I am sure most people are aware, is actually several drugs, pressed into one.

Atripla, which contains efavirenz + tenofovir + emtricitabine, AKA Sustiva, Viread, and EMtriva, is no more or less effective than taking those three drugs individually. Formulated into a single pill, it is (as of this date) the easiest pill to take for HIV.

It is this ease of use that, I fear, creates a mindset who which I refer as "vitamin AIDS."

It is absolutely the easiest regimen to take. HIV meds in general are also considered, still, some of the potentially harshest methods of chemical therapy (called Chemotherapy) used outside of an outpatient hospital setting.

Many people with HIV have pre-existing mental health issues such as depression or anger issues. In these people, the CNS impact of Atripla cannot be dismissed or understated.

It is not unusual for these unwanted effects to manifest after several months on the drug. This is why careful monitoring of the patient is necessary, not only by hsi HIV doctor but also friends and family should take note of changes in behavior. Aggression, paranoia, thoughts of suicide are NOT confined to persons with previously diagnosed mental illness. Often, latent chemical imbalances manifest. Several suicides, and it is suspected, several homicides have occured while under the influence of this drug.

HIV resides in the human brain. Many drugs do not cross the barrier between the bloodstream and the brain. It is not uncommon that, when a drug manages this feat, Central Nervous System effects manifest themselves. For some, these effects are as benign as vivid dreams and dizziness that may subside over a few weeks or months. Sometimes simply taking the pill before bedtime negates any potential problems.

Being honest with one's self, open enough to accept objective critiques regarding changes in mood or behavior, and continuing that honesty with one's doctor can go a long way towards mitigating these effects. Sometimes counseling helps, and sometimes changing medication is warranted.

The unwanted effect from the Viread aspect of Atripla mainly impact persons with pre-existing kidney issues, something that blood work can detect and monitor. Lactic acidosis and severe liver problems have been reported, in enough quantities to necessitate a careful eye insofar as blood work is concerned. Pregnant women are especially susceptible to lactic acidosis, as this manifests in greater numbers when patients are taking NRTI meds like Viread and Emtriva, both components of Atripla.

In addition, osteoporosis and related bone density changes are possible with these meds. People who have a genetic predisposition to those ailments need to have bone density testing at regular intervals. This forum has many stories of broken bones and low bone density manifesting itself as the result of these drugs. Women in particular seem to be prone to that situation, though many men have encountered it as well.

Persons with Hepatitis B need to be carefully monitored when taking (and especially if stopping) Atripla, as the Emtriva component acts as a suppressive force against Hep B, and when stopped suddenly, can actually cause a "flare-up" of the illness. This can be very dangerous to the liver, and while transplants for HIv positive persons are now possible, they are far from common.

And, of course, from AidsMed's own library:

<<HIV drug regimens containing Sustiva, Viread, and Emtriva can cause increased fat levels (cholesterol and triglycerides) in the blood, abnormal body-shape changes (lipodystrophy; including increased fat around the abdomen, breasts, and back of the neck, as well as decreased fat in the face, arms, and legs). These side effects of HIV drug therapy are reviewed in our lessons on Lipodystrophy, Facial Lipoatrophy, and Risks To Your Heart (Hyperlipidemia).>>

These side effects seem far less profound than earlier drugs, and earlier incarnations of these drugs. As time and science progresses, I am certain that these effects will be further minimized. But they are real, and it is not at all unusual for those who have taken HIV meds, including Atripla, for any length of time to need cholesterol medication as well.

Aspirin has side effects as well, and in rare cases can be fatal. This is true of any chemical we introduce into our bodies. People often, and wrongly, assume that Over The Counter meds are harmless, and cannot interact with prescriptions. This is simply not the case (St. John's Wort comes to mind).

However, Atripla is not aspirin. It is one of the mot potent medications prescribed to treat one of the deadliest pathogens in the last seventy years. For many people, taking Atripla presents a brief blip in their routine schedules.

And this is one of the most profound advancements in medical history. The newest meds used to treat HIV are truly modern medical miracles. They work for many people. But are serious enough to be investigated thoroughly, and taken with care. The commitment to taking these meds every day for (currently) the rest of one's life can be daunting, especially during the first year or so of diagnosis when a person might be grappling with depression, stigma (self imposed or external) and other life changes.

In addition, cost is a factor. several members who once touted HIV as a total non-issue have found themselves scrambling to ask assistance (often from the same LTS people they derided) when their jobs downsized, or when they graduated college and tried to get employment in this economy, or when they lost their jobs or income or insurance. It is almost impossible for a non-wealthy individual to pay for these meds out of pocket in the USA. And though many meds are offered in generic form overseas at dramatically reduced prices, ordering and receiving them is often problematic.

HIV drugs are not spooky. But they are not benign. They are extremely effective and extremely powerful drugs, which require a stability of income (or insurance) and commitment to adherence that has few peers in medical treatment.

I was going to post this in Just Tested Positive, because the topic was "Living with HIV." But have decided to start it's own thread in Living With HIV because this really is about THAT, more than about the issues for the newly tested.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Thank you for this, Jonathan. Though (for whatever reason) I've lately been labeled some sort of Negative Nancy when it comes to current HIV treatment, I've been one of the longer standing members that has repeatedly stated that once newer HIV meds (newer than even Atripla) were FDA approved that there was IMO a sea change in treatment optimism (think Prezista, Isentress, Intelence, etc.). However, making statements that one won't ever get sick, or never have side effects, even from those named meds is simply poppycock, pish posh, etc.

I honestly understand the anxiety that comes with commencing a drug regimen for the rest of your life, as well as the continual drone of doctor appointments even if they've been lessened to 3 a year. But one can only manage this anxiety with knowledge, not burying one's head in the sand. If, after a reasonable amount of time, a patient still finds themselves with an overbearing sense of general, daily anxiety no amount of posting on an internet message board will help -- they should seek the counsel of an experienced mental health professional. For some reason I'm always surprised that this avenue isn't explored, as the mental component of a life-threatening disease is every bit as important as the physical one, totally integral to disease management.

nychope1

Thank you for all of that great information provided in one place. At the time before Atrpla I had to really search around to read all about it.

Even my wonderful doc, who I mentioned before, had much much less trepidation about this then what I read around here. He was on the front lines since the beginning of the epidemic.

This information is very valuable to then get comfortable in taking the stuff. It was for me. Things like Lipo and all...well, probably not going to happen from Atripla and a lot of the other drugs for the newly diagnosed.

I read all I could. Everywhere. About every drug available. At the end of the day one probably should do that but not get hung up on what is going to be in 20 or 30 years or side effects. Go listen to the next commercial on TV for a new drug. It is a comedy routine.

As someone so eloquently said here... the best way to find out if a med works for ya is to take it. Great advice.

At the same time, jknati2, (AS YOU MENTONED) can go into my medicine cabinet and pull out several medicines that have nothing to do with HIV and have as many side effects. Some over the counter drugs have tons of side effects and implications.

So, yes, your doc will naturally monitor you for all of those things mentioned. Every three or four months, if you are lucky every six months.

It is my daily vitamin. That's exactly what it is.

So go on and nit pick about my choice of words using "no big deal" but that's what it is to me. (That's how we talk here in NY I guess) Hopefully the newly diagnosed will find some comfort in that.

Thank you for all of that great information provided in one place. At the time before Atrpla I had to really search around to read all about it.

Even my wonderful doc, who I mentioned before, had much much less trepidation about this then what I read around here. He was on the front lines since the beginning of the epidemic.

This information is very valuable to then get comfortable in taking the stuff. It was for me. Things like Lipo and all...well, probably not going to happen from Atripla and a lot of the other drugs for the newly diagnosed.

I read all I could. Everywhere. About every drug available. At the end of the day one probably should do that but not get hung up on what is going to be in 20 or 30 years or side effects. Go listen to the next commercial on TV for a new drug. It is a comedy routine.

As someone so eloquently said here... the best way to find out if a med works for ya is to take it. Great advice.

At the same time, jknati2, (AS YOU MENTONED) can go into my medicine cabinet and pull out several medicines that have nothing to do with HIV and have as many side effects. Some over the counter drugs have tons of side effects and implications.

So, yes, your doc will naturally monitor you for all of those things mentioned. Every three or four months, if you are lucky every six months.

It is my daily vitamin. That's exactly what it is.

So go on and nit pick about my choice of words using "no big deal" but that's what it is to me. (That's how we talk here in NY I guess) Hopefully the newly diagnosed will find some comfort in that.

Quoted from an expert that was diagnosed two months ago. You have a lot to learn.

nychope1

I think you have more fear about this than you let on. If this is such a cakewalk for you why waste your time here?

I am naturally not a fearful person. About most everything in my life. That can be troublesome sometimes.I was however very fearful about starting meds even though I spoke with a lot of people who share my sentiments about it. I am here because I am off from work this week and am probably wasting too much time right now.On a serious note... I care enough to take the time to post this somewhat over zealous positive attitude so that someone here may find comfort from it. My opinion is not for everyone and one size don't fit all. I wonder why this is so bothersome to some...

"But how can it be a big deal. All the men I seen in ads are happy, active and really super HOT! I chose my treatment because that blond was really built." I think in pushing us to choose their drug, pharmaceutical companies have packaged their ads in a way that helps promote this no big deal mentality.

When I talk about my meds, I always preface what I say with something like "for me" or "from my experience" because for me at this time I have had no problems. I then always say that I am not sure what will happen in 10-15 years because there is no telling the damage that is being done to my body. As a matter of fact in my first appt with my specialist as we discussed meds he said that the odds of me dying from AIDS were not nearly as great as complications from the meds. Recently I am amazed at how much I remember things Moffie used to say. I remember somewhere him saying something to the effect that since HIV is always changing, the meds may stop working completely one day because this living virus we have has managed to develop immunity to the drugs we have. The jury is still out and won't be back in for years.

BTW Jonathan, excellent posting.

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"Let us give pubicity to HV/AIDS and not hide it..." "One of the things destroying people with AIDS is the stigma we attach to it." Nelson Mandela

One of the things that pops up now and again, most often from newly diagnosed members, is the notion that when one develops resistance to a combination (or class of drugs) it is somehow the "fault" of the person, the patient. Doctors are, sadly, usually the first to accept this.

People who are coerced into starting meds before they are ready are most at risk. And some on this forum have, at times, shown some really judgmental attitudes. The notion that this is a cakewalk makes such judgments easier to pass.

That is, of course, another discussion. But it is directly related to this one, and yet another reason why perhaps the most important medical decision in a person's life deserves gravity and careful consideration.

I honestly think that the way to overcome fear is not to deny it, but face it, push through it, and temper blind faith and hope with the clarity of an open mind and open eyes.

And Woodshere, not a day goes by when I don't remember the things Moffie said. They are as relevant now as they always were. Sometimes when I find myself outraged, I think I try )in vain) to channel that wise, cranky man.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I do not really get the point of this thread, but let me side by Miss P on all aspects of her post.

Especially "one can only manage this anxiety with knowledge"

I've come a long long long way in the last 6 months and this forum has been of immense help.

There is a mixed bag of people here... Newly infected (and less anxious because they know science has made great leaps forward) people who have been infected 10-15 years ago and have fought the up hill battle losing loved ones on the way. People born with the virus, people taking meds, some not.Some have a long history with the virus, some not

Some favor disclosure, some not, some can afford treatment, some not.

I agree that "no big deal" is false.

But I hope that we (collectively) can put all this in perspective, nonetheless.

Of all the nasties I see around me (friends fighting colon cancer, parents with Alzheimer, colleagues with type I diabetes, etc.)Of all the misery for life (unemployment, stress, debts ) that lurk around, I think the HIV is pulling so many theads and going so deeply in the complexity of science/society/public health/what-have-you

that I am starting to find it absolutely FASCINATING (and my apologies to those who have deeply suffered and may find that statement ludicrous)

I agree that "no big deal" is false.

But if life was easy, it would not be that enjoyable

And life is FUN !

We CAN collectively put things in perspective and help each other gain the momentum to FIGHT

These are very honest posts, and as much of a downer as this thread seems to be, it is certainly a wake up call. I'm not afraid of dieing... I'm afraid of being humiliated by people and being sick as hell. This isn't like the MTV Real World where that young Gay boy died years ago and there's all this love and support around me. This is the real world of fear and discrimination and hate and ignorance. I used to think/plan/ to just go quietly into the woods and just starve and die, never to be found. But that's not the case, so here I go Sunday starting these new meds that kinda scare the ____ out of me but into the void I go, not knowing what a month or a year will bring. So yea, starting the meds and continuing on the meds are a big deal. Thanks JKinATL2 for the thread and the very clear description of what this life on meds is all about and to Miss P, I never thought you were anything but honest also. And I do continually thank everybody on here because I do appreciate all of you being around because it would truly suck to do this alone!And I'm hoping the meds will work for me and not make me sick but I don't want to die this year, so I'm going to give it my best. Cheers to the Long-term Survivors. And you all can be very funny sometimes too.

jk...Awesome post. Its really quite a head trip being newly diagnosed and facing it all. I admire NYChope for his optimism but I'm not there. I'm just not, and Its fine. Thanks for the post though, I'm kind of tired of people blowing sunshine up my ass , like taking meds is equivellant to flinstones vitamins and HIV is no big deal. Its a huge deal for me, and im still trying to deal.

I regularly get private messages from 2 members asking me about HIV and their fear of HIV and meds. I rarely see these members posting in threads. I'm not sure why they have sought me out. I'm definitely no expert and have a lot to learn myself. Maybe these 2 are contacting several people here. I keep my responses to my own experiences about becoming poz, learning my diagnosis, and coping. I avoid answering anything I don't know enough to answer.

Both always talk about reading posts from members here who have medical issues despite being on meds. I don't know exactly how to answer that. I've read where many docs/experts say this is due to people infected years ago and started on the older meds that were really toxic. Many of those docs and experts tell us people starting on today's meds shouldn't have all those issues. These 2 members will say they've read posts from people who were infected before HAART, but were able to hold off on meds until HAART and still have a lot of medical issues. Or, they'll talk about people who have been infected less than 10 years, started meds, and now have liver issues or other problems. They fear the meds are causing those problems. I respond saying it is hard for me to keep up with who started meds when, who was infected when, or who is having medical problems. I will just tell them I have the same concerns about what life with HIV is really going to be like.

I'll read things experts and docs write where they say most people doing great are probably not members of forums like this and that forums like this give a skewed sense of what is really going on. I believe one compared it to people who write complaints on store websites--you mostly get the people who were dissatisfied with a product and not the people who loved the product. Another example was political protests-- you usually only see people angry with government and not people happy with the government. Their words, not mine.

So, what is the consensus here? Do many here believe there is a high probability that most with HIV will run into those health issues regardless of starting on those pre-HAART drugs or starting today? Since HAART hasn't been around all that long, how are experts so certain about lifespan and quality of life living with HIV and the newer meds? They are going off of studies and mathematical models, and I sucked at statistics, math, and chemistry. So, as I said, I keep my responses to my own experiences and how I'm not much further ahead of them in coming to terms with HIV and educating myself about HIV and meds.

Well done Jkinatl2 ,Nychope1, Miss P some excellent points very well made. Apart from a couple of posts from members who have totally seemed to have missed the point. To me it's a discussion on living with HIV today, and possibly applying more to those have been relatively recently diagnosed, ( I say that because LTS may have to deal with long term affects of the virus and or the longterm side effects of Meds, and I can't comment on those issues )

May be this is a good place to give a bit of background information on the time of my diagnosis. At the time of my diagnosis I knew very little about the virus, no more than average lay person I guess. Through my own stupidity I believed this was a problem for African and Gay communities ( I blame the media, even now Pope only advocates condom use to homosexual prostitutes, Outrageous !) Why cant the media accept HIV does not discriminate on race gender or sexuality.

My first meeting with my Doctor lasted about an hour, It was probably the most important meeting I had with him. He is an African Doctor who was treating Aids patients in Africa from the start, in early 80's , he told me about the days no ARV's very little other kinds of meds only kind words to treat his patients.( I'm sure you can picture the situation) Now he works in London. He has been treating HIV for 30 years, so I take very seriously any thing he has to say about it. He said this virus can be deadly but modern meds are very good at keeping the VL down, and yes they do have side effects, but less than meds of 10 years ago. Any way when I finally managed to stop crying it was the last 30 minunites of the conversation that was most interesting, he said in his experience, patients who responded to treatment and coped best (with the virus and meds ) were those who had a positive attitude and less susceptible to stress and anxiety . I say this because to me the underline message of Nyhope's posts are try to stay with a positive state of mind, I think he ( sorry if you are a she Nyhope ) is absolutely correct and admire his perseverance. Yes HIV is nasty but there are other nasty things people have to deal with all the time. Don't try to tell a kid dying of leukemia how bad your HIV is. I accept to some it may be very difficult to controll stress and anxiety, but like working out to improve ones fitness, I believe you can train yourself to controll these emotions. First of all accept you have the virus, get over the anger, try to move on. Then deal with each issue as it arises, there are many experts and LTS here who give good advice on many issues one may have to deal with, I thank them for that

jkinatl2I do not think it is very polite to start a thread by quoting another member's words from a different thread. If you want to express your opinion, just do so. Nobody says you can't feel or believe what you wish.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

jkinatl2I do not think it is very polite to start a thread by quoting another member's words from a different thread. If you want to express your opinion, just do so. Nobody says you can't feel or believe what you wish.

Mecch, I thought it was extremely polite to address the comments, plural, in a thread in the appropriate forum rather than derailing a thread in another forum in which my participation was explicitly not desired.

Moreover, I am not on this forum to be polite regarding HIV, nor do I answer to you regarding my level of civility. I urge you to report my posts that you find offensive, and place me on ignore if you cannot tolerate my tone.

Sad thing about being polite is that it took me five minutes and almost a hundred words to convey what ten seconds and a mere two would have accomplished.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Many many people living with HIV are very optimistic about HAART. So you didn't need to hold out someone specific. Just state you opinion and let others react to it as they may. That's all I'm saying.

You can have whatever agenda and politics you want about HIV.

I don't see any reason to report your post as offensive. I think its not the best way to put forward your personal position on these issues.

As for the issue itself, I don't think its at all helpful to argue for more worry about the long-term prognosis and consequences of HAART. Its the best we have for the moment and its pretty good. Its the glass half full or half empty question. Both are correct, but one is kinder on the system. Optimism and peace of mind and a feeling of security are very very important for healthy living.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

Mecch made fair and valid point, I don't think it was rude or impolite.

Agreed

I am absolutely not overreacting to a mindset that directly causes complacency and leads to new infections.

Trust me, when I observe fallacies in HIV ideology, I shall address them openly. They do indeed push my buttons, as they directly lead to complacency and new infections.

The mindset is perilously close to AIDS denialism, which does indeed push my buttons as it has killed many thousands of people.

I believe that this conversation is very important, especially considering the number of similar posts by several newly diagnosed members reflecting the same mindset.

Insofar as passive-aggressive posting is concerned, I respectfully submit the following signature line:

Quote

How's that hopey, no big dealy thing workin' for ya?

Perhaps a solution is to start an HIV site, for people who have not, and if my understanding of your posting history is correct, will not develop AIDS. and no, I am not being snarky. It simply seems that we are at an impasse as to what this site should address, and how.

In the meantime, I will continue my mantra of understanding and respecting the power of HIV and the meds used to treat it, while at the same time remaining optimistic that current and future therapies/developments will continue to save and preserve lives.

The logic in these childish rebuttals fails when people assume that I am not optimistic about HAART. I have never said, nor intimated that. What I am not, is complacent about this disease, nor am I in denial about it's destructive power, or the potency of the drugs used to treat it.

I have absolutely no intention of altering my style of posting, and until medical science proves that HIV is No Big Deal, and the meds used to treat it are no more powerful than children's vitamins, I shall continue to address the fallacies where and when I find them.

It is a fairly large site, and an even larger internet. Feel free to ignore me if you do not like my tone or my opinions. It really is fairly easy to accomplish.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

For the sake of civility and to avoid a precedence of starting threads by using out of context qoutes by other members I respectfully ask that this thread by renamed.

Thank you...

Nyc, JK wasn't actually using a direct quote. You don't own that phrase, nor did you coin that phrase. I have heard it used many times, by many people, in the context of hiv infection in today's world - at least in the wealthier nations of the world.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

For the sake of civility and to avoid a precedence of starting threads by using out of context qoutes by other members I respectfully ask that this thread by renamed.

Thank you...

Are you really serious? This thread had a very good discussion going on and then u enter with a post like this. WHY? You wrote yesterday in one of your posts that you coined a phrase being used alot here now. I assume you are referring to "no big deal". If you search the forums you will find that no big deal has a very lengthy history. As a matter of fact one of the first threads I ever started was entitled "Whats the Big Deal with taking Meds" or something like that. It was interesting to see where I was then and where I am now 4 ˝ yrs later. The intent of that thread wasn’t to say meds were no big deal but more so for me to understand why others thought it was, because for me I was having not problems. The thing that struck me was the amount of civility that was present then that seems to have disappeared

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"Let us give pubicity to HV/AIDS and not hide it..." "One of the things destroying people with AIDS is the stigma we attach to it." Nelson Mandela

nychope1

Quote by jkinati2: "I have absolutely no intention of altering my style of posting, and until medical science proves that HIV is No Big Deal, and the meds used to treat it are no more powerful than children's vitamins, I shall continue to address the fallacies where and when I find them."

To quote a former President; "There he goes again"

Qoute by Ann "Nyc, JK wasn't actually using a direct quote. You don't own that phrase, nor did you coin that phrase. I have heard it used many times, by many people, in the context of hiv infection in today's world - at least in the wealthier nations of the world."

Ah, Ann, you moderators obviously have a soft spot for this fella. You are an intelligent person as are most folks here so your statement is beneath you I think. You know very well as most here who have been keeping up JKinati2 was directly quoting me. Be that as it may. Your comment and his speak for themselves.

I think its possible to give hope and support but still be truthful and realistic at the same time .

Saying starting meds is no big deal is just not true if you are dealing with the facts . Jk brought up some excellent points ... My doctors think atripla is responsible for me developing type 2 diabetes and sever lipid issue . They switched my regimen to Isentress and truvada and despite the fact I have no resistance issues the meds are no longer working . I'm wracking up a huge viral load now as well as huge copays for test to straighten out this mess .

I didn't have the heart to go into a thread some one started seeking support because its time to start meds and be anything but supportive but the truth is it is a big deal .

lots of people wont face the problems and side effects that I have faced ... and that my friends is true hope and support .

I think its possible to give hope and support but still be truthful and realistic at the same time . Saying starting meds is no big deal is just not true if you are dealing with the facts . Jk brought up some excellent points ... My doctors think atripla is responsible for me developing type 2 diabetes and sever lipid issue . They switched my regimen to Isentress and truvada and despite the fact I have no resistance issues the meds are no longer working . I'm wracking up a huge viral load now as well as huge copays for test to straighten out this mess . I didn't have the heart to go into a thread some one started seeking support because its time to start meds and be anything but supportive but the truth is it is a big deal . lots of people wont face the problems and side effects that I have faced ... and that my friends is true hope and support .

A true reality check, thanks for sharing!

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"Let us give pubicity to HV/AIDS and not hide it..." "One of the things destroying people with AIDS is the stigma we attach to it." Nelson Mandela

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Nyc, JK wasn't actually using a direct quote. You don't own that phrase, nor did you coin that phrase. I have heard it used many times, by many people, in the context of hiv infection in today's world - at least in the wealthier nations of the world.

And even in the wealthier nations, especially the USA without Universal healthcare, this mindset is troubling. Many people are testing positive well in their formative years, from a financial point of view. People under 30, who might not have a career in which they intend (or desire) to remain for the rest of their working lives, people without health insurance (or whose insurance is insufficient to deal with an indefinite thousand dollar a month medical treatment).

People who are naive enough to think that their employers will not decipher the cause of a huge spike in the company rates, and will not take measures to eliminate that threat to their overall healthcare costs. People who actually think that employers would willingly hire and insure someone whose healthcare costs will negatively impact their organization (this is particularly true in small companies, which are filled with largely younger employees).

ADAP is no walk in the park. It is a time and energy consuming system to acquire medication. It is also underfunded to the point of waiting lists, and has been for several years now with no real upswing in sight. Moreover, ASO's are struggling to keep and replace case managers, who are often LTS' themselves. These people are aging out, and in some cases, dying out - yes, of AIDS.

Many ASO's are branching out to treat cancer patients and other segments of the population, and are being staffed with incresingly undereducated and underinformed personnel. The gay community itself has once again begun to see AIDS as a disease of the Olds, and the structures on which which young, recently diagnosed people depend are crumbling.

When this site simply tells Klub Kids to throw a Truvada in with their meth and bareback all they want, I will respectfully withdraw from the site, AIDS being officially over.

I might interject that one of the CNS effects of Atripla is sometimes hostility and rage, as well as depression. I will try to be mindful of the various elements that might lurk behind what appear to be simple trolling or flame-baiting. Often people are in pain they cannot articulate, and sometimes i fail to peer behind the words and practice compassion. I will not, however, sacrifice facts in that endeavor. I leave that effort to greater, more noble souls than mine.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I am not surprised by the tenions being played out in these,very useful posts.

I think there is a huge tension in the current medical response to HIV/AIDS , there are plenty off excellent reasons to get people to test and know there status, I think that with the unquestionable progress in treatment coupled with the benefits off testing has lead to only the really glossy easy side off HIV/aids being concentrated on.

With the lessening off safe sex education added to this mix no wonder we are where we are.

The drugs available reduce the odds on developing OI,s they do not not eliminate it.

They do damage to HIV and the body.

The drugs available have not been around long enough to be able to know there real long term effects.

After 25 years off this I know I will have to deal with things I have not considered fully yet. That's about the one thing that has remained constant that HIV it is a complicated deadly virus with various stages. We are still a long way off Knowing all.t

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"If we can find the money to kill people, we can find the money to help people ." Tony Benn

Trust me, when I observe fallacies in HIV ideology, I shall address them openly. They do indeed push my buttons, as they directly lead to complacency and new infections.

The mindset is perilously close to AIDS denialism, which does indeed push my buttons as it has killed many thousands of people.

You have a good vocabulary but you sound like a 19 yo critical studies major.

Being thankful for HAART and optimistic about a long life living with HIV has nothing whatever to do with AIDS denialism. And maybe not with new infections. Because really most HIV- people are afraid of AIDS and don't want it, even it they hear HIV is a "chronic condition" and hear good news from their HIV+ friends or the media.

Sounds to me at the end of the day you have a lot of fear. Just don't set up a boogyman opponent. I'll debate you if you want but don't make others debate you if they don't feel inclined.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

You have a good vocabulary but you sound like a 19 yo critical studies major.

Being thankful for HAART and optimistic about a long life living with HIV has nothing whatever to do with AIDS denialism. And maybe not with new infections. Because really most HIV- people are afraid of AIDS and don't want it, even it they hear HIV is a "chronic condition" and here good news from their HIV+ friends.

Sounds to me at the end of the day you have a lot of fear. Just don't set up a boogyman opponent. I'll debate you if you want but don't make others debate you if they don't feel inclined.

If you have nothing germane to add to the discussion, then please refrain from personal attacks is you can. I have zero interest in debating you or anyone else on this site. I only correct misconceptions and factual errors when I encounter them.

I am very optimistic about living a long life, and thrilled about the success of HAART. I have never indicated otherwise.

And your condescension regarding my perceived fear is noted. It is posts and posters such as yourself that keep me from ever using this forum for personal support. I hope you realize what damage that does to it's intended purpose.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I am absolutely not overreacting to a mindset that directly causes complacency and leads to new infections.

Trust me, when I observe fallacies in HIV ideology, I shall address them openly. They do indeed push my buttons, as they directly lead to complacency and new infections.

The mindset is perilously close to AIDS denialism, which does indeed push my buttons as it has killed many thousands of people.

I believe that this conversation is very important, especially considering the number of similar posts by several newly diagnosed members reflecting the same mindset.

Insofar as passive-aggressive posting is concerned, I respectfully submit the following signature line:

Perhaps a solution is to start an HIV site, for people who have not, and if my understanding of your posting history is correct, will not develop AIDS. and no, I am not being snarky. It simply seems that we are at an impasse as to what this site should address, and how.

In the meantime, I will continue my mantra of understanding and respecting the power of HIV and the meds used to treat it, while at the same time remaining optimistic that current and future therapies/developments will continue to save and preserve lives.

The logic in these childish rebuttals fails when people assume that I am not optimistic about HAART. I have never said, nor intimated that. What I am not, is complacent about this disease, nor am I in denial about it's destructive power, or the potency of the drugs used to treat it.

I have absolutely no intention of altering my style of posting, and until medical science proves that HIV is No Big Deal, and the meds used to treat it are no more powerful than children's vitamins, I shall continue to address the fallacies where and when I find them.

It is a fairly large site, and an even larger internet. Feel free to ignore me if you do not like my tone or my opinions. It really is fairly easy to accomplish.

Just let me quote this for epic truth.

JK is spot on with this stuff. Some people get their feathers ruffled when the unpalatable realities of HIV are pointed out. Full points to you Jonathan for saying (once again) that what needs to be said.

As for the malarkey from Meech and Sam about this thread being "inappropriate". Matty the Damned sez take a pill already, the pair of you.

Many many people living with HIV are very optimistic about HAART. So you didn't need to hold out someone specific. Just state you opinion and let others react to it as they may. That's all I'm saying.

You can have whatever agenda and politics you want about HIV.

I don't see any reason to report your post as offensive. I think its not the best way to put forward your personal position on these issues.

As for the issue itself, I don't think its at all helpful to argue for more worry about the long-term prognosis and consequences of HAART. Its the best we have for the moment and its pretty good. Its the glass half full or half empty question. Both are correct, but one is kinder on the system. Optimism and peace of mind and a feeling of security are very very important for healthy living.

Seriously Meechie, JK has shown impeccable forums ettiquette with this. If he had continued the conversation in the other thread I have no doubt you'd be racing around with your undies on your head shrieking about hijacking and demanding we get back on topic.

You have a good vocabulary but you sound like a 19 yo critical studies major.

Being thankful for HAART and optimistic about a long life living with HIV has nothing whatever to do with AIDS denialism. And maybe not with new infections. Because really most HIV- people are afraid of AIDS and don't want it, even it they hear HIV is a "chronic condition" and hear good news from their HIV+ friends or the media.

Sounds to me at the end of the day you have a lot of fear. Just don't set up a boogyman opponent. I'll debate you if you want but don't make others debate you if they don't feel inclined.

Meech, let it go. You couldn't debate your way out of a Methodist Ladies Auxiliary meeting. JK will wipe the floor with you.

You have a good vocabulary but you sound like a 19 yo critical studies major.

Being thankful for HAART and optimistic about a long life living with HIV has nothing whatever to do with AIDS denialism. And maybe not with new infections. Because really most HIV- people are afraid of AIDS and don't want it, even it they hear HIV is a "chronic condition" and hear good news from their HIV+ friends or the media.

Sounds to me at the end of the day you have a lot of fear. Just don't set up a boogyman opponent. I'll debate you if you want but don't make others debate you if they don't feel inclined.

So let me get this straight. You can say what you want to say, but Jonathan can't. At the end of the day you come off sanctimonious. I'll be glad to debate you if you want. God I can't believe you're in control of impressionable youth.

You have a good vocabulary but you sound like a 19 yo critical studies major.

I didn't think this comment was called for - just because it might not fit into the category of "name calling," it is still meant to degrade someone's character. I know that you wouldn't appreciate it if this was done to you - so, you make it very difficult for you to call foul about what others may say when you seem to think that it is okay for you to attempt to "slam" a person.

I'm curious what exactly the purpose of this post was. If it was to warn newbies of "things to come", I wonder why exactly one would want to be such a Cassandra. For a lot of people, a little bit of denial makes life a lot easier. In a case like HIV, where stress and outlook probably influence long term consequences, a little bit of denial is probably very useful. There are obviously some rather horiffic long term consequences to HIV. Those of us who are in a mindset to realize and address this do so with regularity. Make no mistake though, newbies who understand this aren't going to give anyone the "I'm doing so much better now that I've found aidsmeds and been told I'll live a normal lifespan" line which is so positively received on here. No normal human being who understands the long term implications of this virus is going to be anything short of despondent upon word of their infection. People who "get it" are going to react as I have...badly. The others will accept what this virus means when they're ready, or when they have to. At this point, you're not doing them any favors by letting them know what their futures might hold.

If this post was to make us aware of the need for more activism and more research, I wonder where the call to arms was.

Was it to compel us to balance the long term consequences of HIV chemotherapy against its benefts?, I honestly don't see the nuance in the post that I see from others who've posted against the "hit it early, hit it hard" mentality.

Was it because you're afraid that people will underestimate the problems that come with HIV, and in doing so be more likely to become infected? Then start telling the "Am I Infected" crowd to stop playing with fire, and leave the issue alone in a forum where most participants are already infected.

Instead, it looks like this was another "you'll learn" post. As in "You'll learn that all the nice things your doctors told you about HIV are a lie, and your life is going to be shit. You'll learn that this virus fucks you up, and that all the beautiful poz talking heads are lies. You'll learn that Regan Hoffman and Jack Mackeroth and Mark S. King are accidents of luck as much as benficiaries of medical science. You'll learn MY pain". Absent a constructive reason behind it, this "you'll learn" mentality does nothing to improve the lives of its intended audience, hence it has no redeeming value to anyone but yourself. It might make you feel better to cackle like the wicked witch, "HIV will get you, my pretty", but it doesn't actually help. In fact, it hurts.

And it hurts those who are least able to handle it. It hurts those who need hope NOW more than at any time in their life. It hurts those who have nowhere else to turn. It hurts those who are scared, and clearly incapable of dealing with what this virus means. Thats a huge price for them to pay so that you can offload your own feelings. Its not "a well rounded opinion that needs to be heard", its a selfish expression.

OK Jkinat Again you make some very good points regarding HIV, yes it's a nasty terrible virus, I dont think any of us deny that or underestimate it. Surely we are discussing best attitude to have with our fight against it. Of course its our responsibility to make sure we do not pass it on to another person.

I do not get the impression NYC , Mecch, or Miss P or anybody else here is advocating unprotected free sex here. And of course we need better meds or a cure, that's why as i said on a previous post we must keep fighting.

Interesting that you asked a question, then answered it for me and then judged it's worth by that answer.

I wrote the post in response to a growing and incorrect notion that HIV is not a serious illness. And you will note that I did not post this in Just Tested Positive. I posted it here. A recent post regarding this very notion was also posted here, in Living With. It was not aimed at people who, as you put it, are unable to handle the information. Had I intended that, I would have posted it in the forum for the Newly Diagnosed. And I imagine that it would have been moved to this forum if asked (and possibly even if not).

Beyond that, I was disabusing the notion that HIV and the meds used to treat it are no big deal. I was remarking that this complacency leads to new infections and poor med adherence. One of the posters who has just started Atripla, arguably the easiest medication to acquire and tolerate from a dosing and funding standpoint, was ALREADY having issues with remembering whether he did or did not forget a dose. This after less than two months after starting meds.

That complacency is the very reason we do not thrust drugs that require an unprecedented degree of adherence upon persons regardless of their ability or willingness to take them, on time, every day for the rest of their lives.

That complacency and inaccurate designation of HIV as No Big Deal also leads to new infections, non disclosure/barebacking when one's VL goes undetected, and the rapid disappearance of the very support systems newly diagnosed persons rely upon to continue their healthy lives.

I have said this over and over on this thread. I really cannot communicate any more directly than I already have as to why I started this thread and why I feel it is important to address. If you do not understand by now why I have a vested interest in this subject, then I am sorry that I have clearly failed to communicate to you.

This forum is Living With HIV. Not Living In Spite of HIV or Living As If There Is No HIV or even Living In Opposition To HIV. Mainly because those mindsets killed off most of the people who subscribed to them.

I think we do newly diagnosed people a great disservice by withholding the facts about the virus. Moreover, we create shame and guilt for those that cannot tolerate meds, or are not adherent, or get sick despite their efforts.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I'm curious what exactly the purpose of this post was. If it was to warn newbies of "things to come", I wonder why exactly one would want to be such a Cassandra. For a lot of people, a little bit of denial makes life a lot easier. In a case like HIV, where stress and outlook probably influence long term consequences, a little bit of denial is probably very useful. There are obviously some rather horiffic long term consequences to HIV. Those of us who are in a mindset to realize and address this do so with regularity. Make no mistake though, newbies who understand this aren't going to give anyone the "I'm doing so much better now that I've found aidsmeds and been told I'll live a normal lifespan" line which is so positively received on here. No normal human being who understands the long term implications of this virus is going to be anything short of despondent upon word of their infection. People who "get it" are going to react as I have...badly. The others will accept what this virus means when they're ready, or when they have to. At this point, you're not doing them any favors by letting them know what their futures might hold.

If this post was to make us aware of the need for more activism and more research, I wonder where the call to arms was.

Was it to compel us to balance the long term consequences of HIV chemotherapy against its benefts?, I honestly don't see the nuance in the post that I see from others who've posted against the "hit it early, hit it hard" mentality.

Was it because you're afraid that people will underestimate the problems that come with HIV, and in doing so be more likely to become infected? Then start telling the "Am I Infected" crowd to stop playing with fire, and leave the issue alone in a forum where most participants are already infected.

Instead, it looks like this was another "you'll learn" post. As in "You'll learn that all the nice things your doctors told you about HIV are a lie, and your life is going to be shit. You'll learn that this virus fucks you up, and that all the beautiful poz talking heads are lies. You'll learn that Regan Hoffman and Jack Mackeroth and Mark S. King are accidents of luck as much as benficiaries of medical science. You'll learn MY pain". Absent a constructive reason behind it, this "you'll learn" mentality does nothing to improve the lives of its intended audience, hence it has no redeeming value to anyone but yourself. It might make you feel better to cackle like the wicked witch, "HIV will get you, my pretty", but it doesn't actually help. In fact, it hurts.

And it hurts those who are least able to handle it. It hurts those who need hope NOW more than at any time in their life. It hurts those who have nowhere else to turn. It hurts those who are scared, and clearly incapable of dealing with what this virus means. Thats a huge price for them to pay so that you can offload your own feelings. Its not "a well rounded opinion that needs to be heard", its a selfish expression.

I didn't think this comment was called for - just because it might not fit into the category of "name calling," it is still meant to degrade someone's character. I know that you wouldn't appreciate it if this was done to you - so, you make it very difficult for you to call foul about what others may say when you seem to think that it is okay for you to attempt to "slam" a person.

Ha ha. Let's see who's got the guns to debate this more or less cleanly.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

My uncle, my father's youngest brother dropped dead at the age of 52 last year. About a month after his doctor told him his physical was "perfect". Apparently some sort of aneurism developed. He was a straight, non-smoker, non-drinker, non-drug abuser in good health. Now, he's six feet under.

We're all gonna die. That's an absolute fact. I guess we could start a fallacy thread about that, too.

To continuously remind people of the negative that might happen while at the same time strenously denying the pozitive that also might happen seems a bit ridiculous to me. I try very hard to understand why anyone would choose to be so absolutely negative while trying to masquerade it as absolute reality.

Some of us are going to die with HIV with CD4 counts over 1000 because some little old lady in Florida forgot to look before she changed lanes.

It's great to have these forums and access to people with knowledge that's based on experience that one can turn to when those issues arise. But, sheesh, couldn't those issues be addressed when they arise as opposed to before?

Well my battery is running down and there's no electricity here. Will look forward to reading this thread.Let's here the argments: listening to Doctors, HIV specialists, research scientists, etc. say there's lots of optimism. That leads to AIDS denialism and new infections. Let's here the arguments. They could be intellectual or researched based. I don't care. Put them out there and we'll debate.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

My uncle, my father's youngest brother dropped dead at the age of 52 last year. About a month after his doctor told him his physical was "perfect". Apparently some sort of aneurism developed. He was a straight, non-smoker, non-drinker, non-drug abuser in good health. Now, he's six feet under.

We're all gonna die. That's an absolute fact. I guess we could start a fallacy thread about that, too.

To continuously remind people of the negative that might happen while at the same time to strenously denying the pozitive that also might happen seems a bit ridiculous to me. I try very hard to understand why anyone would choose to be so absolutely negative while trying to masquerade it as absolute reality.

Some of us are going to die with HIV with CD4 counts over 1000 because some little old lady in Florida forgot to look before she changed lanes.

It's great to have these forums and access to people with knowledge that's based on experience that one can turn to when those issues arise. But, sheesh, couldn't those issues be addressed when they arise as opposed to before?

Let's here the argments: listening to Doctors, HIV specialists, research scientists, etc. say there's lots of optimism. That leads to AIDS denialism and new infections. Let's here the arguments. They could be intellectual or researched based. I don't care. Put them out there and we'll debate.

Stickler for the correctiness of the Queen's English that you are Meechie, I know you won't mind me pointing out that it's "hear the arguments."